Posteriorly Pointing ACoA Aneurysm

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Clip ligation of posteriorly pointing ACoA aneurysm is associated with additional risks during the necessary manipulation of the hypothalamic, perforator and additional removal of the gyrus rectus to a low expanded exposure of the ACoA complex. This is a 62 year old male who presented with a three millimeter, essentially blister ruptured poster pointing ACoA aneurysm. These blisters aneurysm in this may actually lack a very robust wall. You can see the location of this blister aneurysm off of the ACoA pointing essentially superiorly and slightly posteriorly. This aneurysm may have actually two small blisters associated with it, the based of the aneurism is very wide and the aneurysm is essentially located over the ACoA complex. And most likely has a perforator along it's neck. Left frontotemporal craniotomy was completed so that this aneurysm can be primarily clip like it. You can see that left A1 artery of hubner. Right, A1 left A2 and the other A2 be located, adjust medial to it. You can see the hypothalamic perforator associated with the neck of the aneurysm. This anatomy becomes more apparent via this piece of the video. If you can see the neck of the aneurysm is being developed, from the origin of the perforating vessel. a fenestory clip was used to clip like the aneurysm without placing the origin of the twos at risk. falling deployment of the Crip, interoperative falcine angiography revealed pit and see of all the surrounding vessels, including the hypothalamic perforator. Here you can see the clip is essentially placed over neck of the aneurysm. Postoperative angiogram demonstrates adequate exclusion of dislation. Thank you.

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